Individual provider Active NPI

Ajay K Shukla, PHARMD

  • Pharmacist
  • Lawrenceville, NJ
National Provider Identifier
1336573260
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03574400 Issued in NJ
Practice address
3401 Princeton Pike RM C.4254H
Lawrenceville, NJ 08648-1205
Phone
(609) 302-5778
NPI assigned
Aug 27, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03574400 NJ Primary

Addresses

Primary practice location

3401 Princeton Pike RM C.4254H
Lawrenceville, NJ 08648-1205

Mailing address

3401 Princeton Pike
Room C.4254H
Lawrence Township, NJ 08648

Other practice location 1

703 Ginesi Dr
Morganville, NJ 07751-1235
Phone (732) 617-8686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
28RI03574400NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ippc Inc Pharmacist Past Accepting new patients
Ippc Inc. Pharmacist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1336573260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 PRINCETON PIKE",
            "address_2": "ROOM C.4254H",
            "city": "LAWRENCE TOWNSHIP",
            "state": "NJ",
            "postal_code": "08648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 PRINCETON PIKE RM C.4254H",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086481205",
            "telephone_number": "609-302-5778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "703 Ginesi Dr",
            "address_purpose": "LOCATION",
            "city": "Morganville",
            "state": "NJ",
            "postal_code": "077511235",
            "country_code": "US",
            "telephone_number": "732-617-8686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "AJAY",
        "middle_name": "K",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03574400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.